This is a K-24 ('Mid-career investigator Award in Patient-Oriented Research') application by W. Ray Kim, MD entitled, Patient-Oriented and Effectiveness Research in Chronic Liver Disease. Chronic liver disease has a widespread health burden in the United States. It is the fourth most common cause of death in Americans aged between 41 and 50 years of age, indicating that it causes many premature deaths. Dr. Kim is one of the most productive researchers in patient-oriented research in liver disease. The most widely recognized achievement in Dr. Kim's research is the development, validation and refinement of the MELD score. He is also well known for his expertise in epidemiology, diagnosis, treatment and prevention of chronic viral hepatitis including hepatitis B and C. Since he joined the faculty at Mayo Clinic College of Medicine, he has led numerous research projects working with young investigators, many of whom continue their endeavors in academic medicine. He also organized educational programs in patient- oriented research methods on behalf of international academic societies. Dr. Kim's research program to date has been supported by three federal grants. The first grant continues to evaluate the MELD score and investigates chronic kidney disease in the setting of liver transplant candidates and recipients (R01). The second grant constitutes a pilot trial to test the hypothesis that nitric oxide plays an important role in post-transplant chronic kidney disease (R21). The third grant is a multicenter network to conduct research in hepatitis B (U01). In this application, Dr. Kim is requesting support of his time to mentor junior faculty members, fellows, residents and medical students working in patient oriented research. These mentees are mostly trainees at Mayo Clinic, but given the international background and reputation, selected individuals from institutions outside the US will also be included. Secondarily, the support will be used to enhance and supplement Dr. Kim's research expertise, specifically in the area of comparative effectiveness research and genetic epidemiology and bioinformatics. His mentoring plans include (1) formal methods training in patient-oriented research through the Center for Translational Science Activities (CTSA) and other didactic material at Mayo Clinic, (2) hands-on guidance for research experience in conducting individual projects, which includes study design, data collection and analysis, presentation and publication, and application for funding; and (3) one-on-one mentoring to accomplish career milestones in research from residency electives to fellowship training to junior faculty development. Strong Divisional and Institutional support exists to ensure the success of the mentoring program.